I. Description of Culture A. His

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					I.   Description of Culture
     A. History
        •   The Cambodian culture is at least 2000 years old
        •   Cambodia was a French colony from 1862 until 1953 when it became
            an independent kingdom
        •   In 1975 the Khmer Rouge (“The Killing Fields”) movement, under the
            leadership of Pol Pot, overthrew the Cambodian government and
            carried out a radical program of evacuating cities, closing factories and
            schools, and herding people into collective farms. Intellectuals and
            skilled workers were assassinated. Approximately 1.7 million people
            lost their lives (21% of the country’s population) as a result of
            starvation and brutality.
        •   The biggest wave of Cambodian refugees entered the United States in
            1981 from Thailand. Large numbers continued to flood in until 1985.
            After 1985, only small numbers immigrated each year in conjunction
            with family reunification programs.
     B. Demographics
        •   The number of Cambodian refugees and immigrants admitted in the
            United States is slightly over 176,000
        •   The greatest numbers of Cambodians live in California and
            Massachusetts.
        •   Around 760 currently live in Maine (mostly in Portland)
     C. Religion
        •   Theravada Buddhism is the official religion in Cambodia; Buddhism
            teaches that most of the suffering experienced in life can be traced to
            desire or passion. The way to escape suffering is by diminishing one’s
            desires, lust, aggression, avariciousness and deceit. Buddhists believe
            in reincarnation.
        •   Approximately 90% of Cambodians are Buddhist
        •   10% are either Muslim or Christian
D. Food
   •   Traditionally Cambodians eat together as a family usually three times
       a day
   •   Rice and fish are the most common foods eaten, but their diet also
       includes chicken, eggs, pork (non-Muslim), and occasionally beef, as
       well as lots of fruits and vegetables.
   •   Rice is expected at every meal
   •   Dairy products are much disliked and avoided. Cambodians may be
       lactose intolerant.
   •   Spoons and forks are most commonly used, rarely chopsticks.
E. Holidays/Celebrations/Rituals
   •   Cambodian New Year is celebrated around April 14 – 16. People clean
       and decorate their houses, and prepare beautiful offerings of fruits,
       drinks, and flowers for the inauguration of New Angels who come to
       take care of the world for a one-year term.
   •   “Vesaka Bochea” is a religious celebration of the birth of Buddha, his
       enlightenment, and the day Buddha entered Nirvana. It is observed on
       May 15.
   •   The “Water Festival” is one of the biggest and most exuberant
       festivals in Cambodia. It takes place in November (August in the U.S.)
       This festival celebrates the rainy season and the abundance of fish. It is
       famous for its traditional boat races, which take place on a large scale.
   •   Birthdays are not celebrated
F. Clothing
   •   Traditional public dress for women consists of a skirt (“sampot”) and a
       blouse
   •   Men wear trousers, shirts and sweaters
   •   A traditional Cambodian multi-purpose garment is the checkered scarf
       called “krama”, which may be used as a shawl, turban, sarong, a towel
       or even a carrying bag.
           •   In the U.S. both men and women wear Western clothing to the
               workplace and traditional dress at home and in their communities
II.    Family/Relationships/Roles
       •   The Cambodian refugee family may be a combination of related
           individuals and fictive (“adopted”) kin who now reside with the family.
           Family loyalty is highly valued
       •   Because wives do not take the names of their husbands, there may be
           several surnames in a single household. A man’s mother, wife and
           children will have different surnames with only the child’s surname being
           the same as the father’s.
       •   Children are highly valued by Cambodians. The ideal number of offspring
           is five. Children are expected to care for and respect their aging parents
       •   The husband is the authority figure in the household and makes decisions
           about important matters affecting the family as a whole or any of its
           members
       •   Elders are respected and valued
       •   Cambodians are accustomed to life in small communities with strong
           support from extended family and friends
       •   Men and women have distinct roles. Traditionally, men work outside of
           the home, while women take care of the children and are responsible for
           managing the household
III.   Communication
       A. Language
           •   Cambodians speak Khmer, which is the official language of
               Cambodia. It is not a tonal language (such as Vietnamese or Thai)
           •   The Khmer system of writing is based on the South Indian alphabet.
               The written language is syllabic (neither alphabet nor character based )
           •   There are differences between spoken “city” Khmer and “rural”
               Khmer. These are immediately apparent to Cambodians, who assess
               education level and social status accordingly.
       B. Greetings/Gestures
          •   Cambodians greet each other with a gesture called “sampeah”. They
              place their palms together near their faces (as if praying) bow their
              head and say “chum reap sur”.
          •   Cambodians are not known to use gestures a lot. Beckoning a person
              with a crooked index finger is considered insulting. Pointing with a
              finger or a foot at someone is also offensive
          •   Cambodians may not maintain eye contact with someone who is older
              or considered a superior because it is not considered polite.
      C. Personal space/Touch
          •   Shaking hands is despised especially with people of the opposite sex.
          •   The comfort zone between people engaged in a standing conversation
              is at least three feet; more if they are of the opposite sex.
          •   There is very little physical contact (except with small children)
          •   Boys and girls (beyond early childhood) and unmarried men and
              women should not touch
      D. Conversation
          •   Cambodians are polite, attentive and respectful in conversation.
          •   The tone of voice and words are carefully chosen
          •   They are not emotional speakers
          •   Lavish praise is embarrassing to them and criticism is taken very
              seriously
          •   Saving face is very important
IV.   Work/Play & Leisure
      •   Cambodians are mostly farmers (80% of population in Cambodia)
      •   Few Cambodians have overcome the obstacles in the United States for
          employment. Those who have generally own and/or work in restaurants,
          grocery stores, jewelry stores, factories, or hold janitorial positions
      •   Many Cambodians in the United States are unemployed and receive
          assistance from the government
      •   Cambodians enjoy soccer and water sports such as swimming and rowing
      •   Martial arts such as kickboxing are widely practiced
      •   Dance is a very popular form of leisure and play. There are two major
          types of Cambodian dance: Classical, which was used to laud the members
          of the royal class until 1970, and Folk, which depicts popular fables and
          tales and is used during cultural festivals and weddings.
V.    Health/Wellness
      •   Many adults wish to bathe two or more times a day. Children are bathed
          even more frequently
      •   The concept of balance between life forces, energies, and hot/cold foods is
          important to Cambodians
      •   The head is a sacred place on the body for Cambodians. It is where the
          spirit resides.
      •   Popular forms of folk medicine practiced by Cambodians are coin
          rubbing, cupping and massage, as well as the use of herbal remedies
      •   Cambodians also consult with traditional healers such as “Kru Khmer”,
          bonesetters, and Chinese herbalists to obtain medical advice or cure
      •   Cambodians wish for the whole family to be present during an
          individual’s struggle with a serious illness and/or death
VI.   Challenges to healthcare
      •   Language is a major barrier for most Cambodians. Many adults are
          illiterate in English and spoken English is very difficult for them to learn
      •   Cambodians do not value preventive medicine and expect a quick cure
          from Western physicians. They value potent medications and injections,
          which doctors are expected to prescribe
      •   They tend to be “passively obedient”, agreeing with clinicians but failing
          to follow through with long-term treatment regimens
      •   Cambodians are extremely modest and will rarely fully undress even in
          intimate situations
      •   In Cambodian culture it is not proper to show any signs of pain, either
          physical and/or psychological
       •   Cambodians do not believe that it is proper to discuss harmful personal
           situations with others; it is seen as a weakness
VII.   Suggestions for healthcare providers
       •   The use of same sex and same age interpreters is most beneficial for any
           spoken language barriers. Avoid using children as interpreters
       •   Khmer language video tapes are available at no charge at some ethnic
           grocery stores for education on medical needs and directions
       •   Ensure utmost privacy when working with a Cambodian client
       •   When possible, female clinicians should be assigned to Cambodian female
           clients
       •   Begin medical and social history interview with conversations of family
           and other casual topics; it is considered rude to begin probing on such
           discreet subjects right away
       •   If a Cambodian client wears an amulet on his/her body, leave it on
       •   Ask for permission to touch or examine the head of a Cambodian (and
           explain why it is necessary)
       •   Use multiple teaching aids such as models, pictures, posters and
           interactive devices while explaining health related information to a
           Cambodian client.
       •   Be aware that Cambodians rely on electronic equipment, such as a
           television set, VCR, cassette player, and video camera to communicate
           with relatives (most Cambodians are illiterate in the Khmer language).
           Using or making training tapes for the home may be an excellent vehicle
           of communication.
                                             References


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Southeast Asia Resource Action Center (SEARAC) (nd). Population Table.
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The Cambodian Culture
         Researched by


         Andrea Cousins
       Margarete Narzynski


          Spring 2003

				
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